Hospice Peachtree, LLC

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

AR 4137 Issued in AR

Legal business name

HOSPICE PEACHTREE, LLC

Practice address

2910 Jenny Lind Rd
#4
Fort Smith, AR 72901-6735

Phone

(479) 494-0100

NPI assigned

Sep 12, 2008

Last updated

Mar 25, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jim Petrus

Title

Chief Executive Officer

Phone

(479) 494-0100

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1023267218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 JENNY LIND RD",
            "address_2": "#4",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729016735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 JENNY LIND RD",
            "address_2": "#4",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729016735",
            "telephone_number": "479-494-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE PEACHTREE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "PETRUS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "479-494-0100"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "AR",
            "license": "AR 4137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Mary Horan, M.D.
• Mark Allen Horne, O.D.
• Emily Horned
• Hortons Orthotic Lab, Inc.
• Hospice Peachtree LLC (Peachtree Hospice)
• Alisa Hostetler, LPC
• William Hough
• Muhammad Houri, MD
• Jeanmarie Householder, MD
• Brooke Houser

• Hospice and Palliative Medicine (Family Medicine) Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.